Human factors, teamwork and leadership on labour ward

It is 02:40. The CTG has been abnormal for ten minutes. The midwife is watching. The junior is mid-bathroom. The senior is at the other end of the ward. The patient is on her own. The gap between the folder and the bed is the human-factors question, and closing it is what this topic is about.^[3]

Overview and definition

Human factors is the science of how humans and systems interact — perception, attention, decision-making, communication, fatigue, tools, layout, team and culture. Crew resource management (CRM) is its application to high-stakes teams: the structured way of working that reduces the chance that a small mistake meets a silent system and becomes a fatal one.^[1][2]

CRM is not a personality trait and not a virtue. It is a discipline with a defensible toolkit. Aviation built it from accident reviews; anaesthesia, surgery, intensive care, emergency medicine and obstetrics have all adapted and tested versions of it. The FRANZCOG candidate who can name the five CRM skills, write an iSoBAR handover and run a PPH drill is the candidate who will not be the subject of the next MBRRACE report.^[1][14]

References21ShowHide

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